JUNIOR INVESTIGATOR, APPEALS and GRIEVANCE

2 months ago


Baltimore, Maryland, United States State of Maryland - Maryland Insurance Administration Full time

Introduction

The Maryland Insurance Administration (MIA) is an independent\r
State agency that regulates Maryland's $46 billion insurance industry and\r
protects consumers by monitoring and enforcing insurers' and insurance\r
professionals' compliance with State law.� Through the diligence of a\r
highly professional staff of market analysts, financial analysts, accountants,\r
lawyers, law enforcement officers, actuaries, complaint investigators, and\r
others, the MIA works to facilitate a strong and competitive insurance\r
marketplace where consumers are well informed and treated fairly.� Staff\r
members are subject matter experts who serve as a resource for lawmakers,\r
consumers, and other public and private entities.�\r
�\r
The MIA is charged with a broad range of responsibilities\r
including the licensure of insurance carriers and insurance producers\r
(brokers/agents) operating in Maryland, the conduct of financial examinations\r
of companies to monitor financial solvency, and the review and approval of\r
rates and contract forms. The MIA investigates reports of consumer fraud and\r
consumer complaints about life, health, automobile, homeowners, and/or property\r
insurance.� Insurance carriers are subject to market conduct examinations\r
and other actions to monitor compliance with Maryland law.� The MIA also\r
has a unit dedicated to consumer education and outreach, which participates in\r
hundreds of events and reaches thousands of individual consumers annually.\r
�\r
*This is a Special Appointment position that serves at the\r
pleasure of the Appointing Authority.\r

GRADE

MIA 0012�\r

LOCATION OF POSITION

Baltimore City or hybrid\r
(between office and telework) \r

POSITION DUTIES

The MIA's Life and Health\r
Division is recruiting for a Junior Investigator in the Appeals and Grievance section.�This\r
position will learn to process and analyze complaints received via U.S. mail,\r
electronic mail, facsimile or walk-in from members, health care providers\r
acting on behalf of members, and representatives acting on behalf of members\r
regarding the denial of a claim or service based on medical necessity. This\r
position will assist higher level Investigators with analyzing\r
responses received from carriers and investigating further when necessary; and\r
will answer general telephone calls from citizens, attorneys, carrier\r
representatives, health care providers, members, and others regarding the\r
complaint process; and update files and record recoveries in the Complaints\r
Tracking Systems.� \r

MINIMUM QUALIFICATIONS

Education: Completion of 60 credit hours at an\r
accredited college or university.\r
�\r
Experience:� Two�years of\r
administrative experience in an office environment.\r
�\r
Note: Additional administrative experience may\r
be substituted on a year-for-year basis for up to two years of the required\r
education.\r

BENEFITS

Our comprehensive benefits\r
package includes a generous leave package; medical, prescription, dental and\r
vision coverage; healthcare and dependent daycare flexible spending accounts; a\r
defined benefit pension plan with optional 457 and 401k supplemental retirement\r
plans; flexible work schedules; and service that may qualify the successful\r
candidate for the Federal Public Service Loan Forgiveness Program.\r
\r
\r
STATE OF MARYLAND BENEFITS\r

FURTHER INSTRUCTIONS

Please contact:\r
for additional information concerning this recruitment.\r
Online applications are strongly preferred. For immediate consideration: upload\r
one (1) WORD or PDF file, that includes your combined cover letter and resume,\r
to the 'Resume' tab. Please indicate your salary requirements in the\r
cover letter.\r
�\r
If you are unable to apply\r
online, you may submit an application packet by mail. �Your submission\r
must be received by close of business, on the closing date for the recruitment.\r
Postmarks will not be accepted.\r
�\r
Complete application packets\r
may be mailed to:\r
Maryland Insurance\r
Administration\r
Human Resources - Recruitment\r
#: # \r
St. Paul Place, Suite 2700\r
Baltimore, MD 21202\r
TTY �Users: call via\r
Maryland Relay\r
We thank our Veterans for their\r
service to our country, and encourage them to apply.\r
As an equal opportunity\r
employer Maryland is committed to recruiting, retaining and promoting employees\r
who are reflective of the State's diversity.\r
�\r



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